TABLE 1.
Identified studies evaluating the consumption of nuts or legumes and incidence of IHD, stroke, or diabetes1
| First author (year of publication) (ref) | Study name | Location | Design | Exposure assessment | Median consumption in lowest/highest categories | Endpoint | Disease ascertainment |
| Nuts (g/wk) | |||||||
| IHD | |||||||
| Albert (2002) (17) | PHS | US | Prospective cohort | FFQ | 4/71 | Fatal, nonfatal | Central adjudication2 |
| Bao (2013) (22) | NHS | US | Prospective cohort | FFQ | 0/159 | Fatal | Central adjudication |
| HPFS | US | Prospective cohort | FFQ | 0/159 | Fatal | Central adjudication | |
| Bernstein (2010) (23) | NHS | US | Prospective cohort | FFQ | 0/79 | Total | Central adjudication |
| Estruch (2013) (3) | PREDIMED | Spain | Randomized trial | FFQ | 47/194 | Total3 | Central adjudication |
| Fraser (1992) (24) | AHS | US | Prospective cohort | FFQ | 14/156 | Fatal, nonfatal | Central adjudication |
| Hu (1998) (16) | NHS | US | Prospective cohort | FFQ | 0/170 | Fatal, nonfatal, total4 | Central adjudication |
| Blomhoff (2006) (25) | IWHS | US | Prospective cohort | FFQ | 0/111 | Fatal | State Health Registry |
| Stroke | |||||||
| Bao (2013) (22) | NHS | US | Prospective cohort | FFQ | 0/159 | Total fatal5 | Central adjudication |
| HPFS | US | Prospective cohort | FFQ | 0/159 | Total fatal5 | Central adjudication | |
| Bernstein (2012) (26) | NHS | US | Prospective cohort | FFQ | 0/67 | Total, ischemic, hemorrhagic | Central adjudication |
| HPFS | US | Prospective cohort | FFQ | 0/119 | Total, ischemic, hemorrhagic | Central adjudication | |
| Djoussé (2010) (27) | PHS | US | Prospective cohort | FFQ | 0/213 | Total, ischemic, hemorrhagic | Central adjudication |
| Estruch (2013) (3) | PREDIMED | Spain | Randomized trial | FFQ | 47/194 | Total | Central adjudication |
| He (2003) (28) | HPFS | US | Prospective cohort | FFQ | 14/213 | Ischemic, hemorrhagic6 | Central adjudication |
| Diabetes | |||||||
| Jiang (2002) (29) | NHS | US | Prospective cohort | FFQ | 0/170 | Diabetes5 | Self-report |
| Kochar (2010) (30) | PHS | US | Prospective cohort | FFQ | 0/213 | Diabetes | Self-report |
| Montonen (2005) (31) | FMCHES | Finland | Prospective cohort | Dietary history interview | 7/607 | Diabetes | The Social Insurance Institution register |
| Pan (2013) (32) | NHS | US | Prospective cohort | FFQ | 0/170 | Diabetes | Self-report |
| NHS II | US | Prospective cohort | FFQ | 0/170 | Diabetes | Self-report | |
| Salas-Salvadó (2014) (33) | PREDIMED | Spain | Randomized trial | FFQ | 62/201 | Diabetes | Central adjudication |
| Villegas (2008) (34) | SWHS | China | Prospective cohort | FFQ | 1/228 | Diabetes | Self-report |
| Legumes (g/d) | |||||||
| IHD | |||||||
| Bazzano (2001) (21) | NHEFS | US | Prospective cohort | FFQ | 7/63 | Total | Central adjudication |
| Bernstein (2010) (23) | NHS | US | Prospective cohort | FFQ | 0/12 | Total | Central adjudication |
| Buckland (2009) (35) | EPIC-Heart | Spain | Prospective cohort | Dietary history interview | 16/66 | Total | Central adjudication |
| Dilis(2012) (36) | EPIC-Greece | Greece | Prospective cohort | FFQ | 10/17 | Total, fatal | Central adjudication |
| Kabagambe (2005) (37) | Cost Rica | Case-control | FFQ | 0/129 | Nonfatal | Central adjudication | |
| Kelemen (2005) (38) | IWHS | US | Prospective cohort | FFQ | 14/96 | Fatal | National Death Index |
| Kokubo (2007) (19) | JPHC | Japan | Prospective cohort | FFQ | 0/30 | Total | Central adjudication |
| Martínez-González (2002) (18) | Spain | Case-control | FFQ | 11/35 | Nonfatal | Central adjudication | |
| Nagura (2009) (39) | JACC | Japan | Prospective cohort | FFQ | 4/26 | Fatal | Death certificates |
| Stroke | |||||||
| Bernstein (2012) (26) | NHS | US | Prospective cohort | FFQ | 6/37 | Total, ischemic, hemorrhagic | Central adjudication |
| HPFS | US | Prospective cohort | FFQ | 6/49 | Total, ischemic, hemorrhagic | Central adjudication | |
| Kokubo (2007) (19) | JPHC | Japan | Prospective cohort | FFQ | 0/30 | Total | Central adjudication |
| Misirli (2012) (40) | EPIC-Greece | Greece | Prospective cohort | FFQ | 9/15 | Total | Central adjudication |
| Mizrahi (2009) (20) | FMCHES | Finland | Prospective cohort | Dietary history interview | 0/10 | Total, ischemic, hemorrhagic | Death certificates |
| Nagura (2009) (39) | JACC | Japan | Prospective cohort | FFQ | 4/26 | Total, ischemic, hemorrhagic | Death certificates |
| Diabetes | |||||||
| Meyer (2000) (41) | IWHS | US | Prospective cohort | FFQ | 12/80 | Diabetes | Self-report |
| Villegas (2008) (34) | SWHS | China | Prospective cohort | FFQ | 12/65 | Diabetes | Self-report |
We used the reported median intake or midpoint of each exposure category to define the median intake in that category. For studies with open-ended lower or higher categories that did not report median intake, we set the lower boundary to zero for lower categories and used the difference from the median to the upper range in the closest adjacent category to impute the median intake in the highest category. When reported intakes were energy adjusted (eg, per 1000 kcal), we estimated absolute intakes on the basis of the mean or median total energy intake. All intakes were standardized across studies to 4 weekly servings (28.4 g) for nuts and 4 weekly servings (100 g) for legumes. AHS, The Adventist Health Study; EPIC, European Prospective Investigation into Cancer and Nutrition; FFQ, Food-frequency questionnaire; FMCHES, Finnish Mobile Clinic Health Examination Survey; HPFS, Health Professionals Follow-Up Study; IHD, ischemic heart disease; IWHS, Iowa Women's Health Study; JACC, Japan Collaborative Cohort Study; JPHC, The Japan Public Health Center–Based Study; NHEFS, NHANES Epidemiologic Follow-up Study; NHS, Nurses’ Health Study; PHS, Physicians’ Health Study; PREDIMED, Prevencion con Dieta Mediterranea; ref, reference; SWHS, Shanghai Women's Health Study.
Disease endpoints were ascertained by an endpoints committee of physicians whereby a physician, who was unaware of the subjects’ risk factor status, reviewed medical records and death certificates (for fatal events). If the cause of death was not adequately documented in the medical records, the next of kin was interviewed about the circumstances under which death occurred.
The study did not separately report risk estimates for fatal and nonfatal IHD, and the risk estimate of total IHD was used for both fatal and nonfatal IHD.
Fatal IHD was not included in the analysis because a report with a larger number of cases from the same cohort was included in the analysis.
Not included in the analysis because a report with a larger number of cases on the same association from the same cohort was included in the analysis.
Ischemic and hemorrhagic stroke were not included in the analysis because a report with a larger number of cases from the same cohort was included in the analysis.
Total intakes of nuts and peas.
Intake of peanuts.